Can Full Enteral Feeds during Therapeutic Hypothermia be Achieved without Adverse Effects? An Observational Study

Objectives: The aim of our study is to evaluate the effects of perinatal asphyxia and subsequent treatment with therapeutic hypothermia (TH) especially on gastrointestinal system in newborns diagnosed with moderate-to-severe Hypoxic-Ischemic Encephalopathy (HIE). The primary objective was to determine the time for initiation of enteral feeds, enhancing the feeds and achieving full feeds in a group of newborns with HIE undergoing TH with secondary objectives to determine the risk of necrotising enterocolitis (NEC), late onset sepsis and duration of hospital stay.

Methods: This is a retrospective study done at Neonatal Intensive Care Unit (NICU), Sarji hospital, a tertiary care centre in Shivamogga, India. A review of the medical records for feeding charts of the babies who underwent TH between December 2018 and October 2021 was carried out. A total of 50 newborns either in-born (n = 3) or out-born and referred (n = 47) to our NICU were included.

Results: Among the 50 babies (both hemodynamically stable and unstable) undergoing TH, feeds were initiated at Day 2 of life. All hemodynamically stable babies were on full feeds by 5th day of life, while 14 out of 16 unstable babies were on full feeds by 8th day of life. For the remaining 2 babies, we could achieve full feeds by 11th day of life.

Conclusion: This study not only supports the recent studies, but also highlights the safety of achieving complete enteral nutrition in neonates (both hemodynamically stable and unstable) undergoing TH without the risk of late-onset sepsis or NEC.